经尿道膀胱肿瘤电切术治疗膀胱癌的临床疗效及对患者预后的影响

Clinical efficacy of transurethral resection of bladder tumor in the treatment of bladder cancer and its impact on the prognosis of patients

目的探讨经尿道膀胱肿瘤电切术(TURBT)治疗膀胱癌的临床疗效及对患者预后的影响。方法依据手术方式的不同将104例膀胱癌患者分为对照组(n=46)和观察组(n=58),对照组患者给予开腹手术,观察组患者给予TURBT治疗。比较两组患者的手术相关指标、肿瘤标志物[糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、癌胚抗原(CEA)]、并发症发生情况和预后情况。结果观察组患者手术时间、尿管留置时间、住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.01)。手术后,两组患者CA19-9、CA125、CEA水平均低于本组手术前,观察组患者CA19-9、CA125、CEA水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率为5.17%(3/58),低于对照组患者的21.74%(10/46),差异有统计学意义(P<0.05)。随访12个月,观察组患者的复发率为6.90%(4/58),明显低于对照组患者的26.09%(12/46),差异有统计学意义(P<0.01);观察组患者的病死率为3.45%(2/58),与对照组患者的8.70%(4/46)比较,差异无统计学意义(P>0.05)。结论TURBT治疗膀胱癌的效果较好,且术后复发率和并发症发生率均较低,预后较好。

Objective To investigate the clinical efficacy of transurethral resection of bladder tumor(TURBT)in the treatment of bladder cancer and its impact on the prognosis of patients.Method A total of 104 patients with bladder cancer were divided into control group(n=46)and observation group(n=58)according to different surgical methods.The patients in the control group were treated with laparotomy,and the patients in the observation group were treated with TURBT.The operation related indexes,tumor markers[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)],complications and prognosis were compared between the two groups.Result The operation time,indwelling time and hospitalization time in the observation group were significantly shorter than those in the control group,and the amount of intraoperative bleeding was significantly less than that in the control group,the differences were statistically significant(P<0.01).After the operation,the levels of CA19-9,CA125 and CEA in the two groups were lower than those before the operation,the levels of CA19-9,CA125 and CEA in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 5.17%(3/58),lower than 21.74%(10/46)in the control group,and the difference was statistically significant(P<0.05).Following up for 12 months,the recurrence rate of patients in the observation group was 6.90%(4/58),significantly lower than 26.09%(12/46)in the control group,and the difference was statistically significant(P<0.01);the mortality rate of patients in the observation group was 3.45%(2/58),and there was no significant difference compared with 8.70%(4/46)in the control group(P>0.05).Conclusion TURBT has a good effect in the treatment of bladder cancer,and the rate of recurrence and complications after operation are low,and the prognosis is good.